AIMS: This study tested the hypothesis that patients with more severe substance use disorders (SUDs) at intake respond better when treated in more structured and intensive settings (i.e. in-patient/residential versus out-patient), whereas patients with less severe SUD problems have similar outcomes regardless of treatment setting. DESIGN, SETTING AND PARTICIPANTS: Up to 50 new patients were selected randomly from each of a random and representative sample of 50 Department of Veterans Affairs (VA) SUD treatment programs (total n = 1917 patients), and were followed-up an average of 6.7 months later (n = 1277). MEASURES: Patients completed a brief self-report version of the Addiction Severity Index (ASI) at baseline and at follow-up. FINDINGS: In mixed-model regression analyses, baseline substance use severity predicted follow-up substance use severity and there were no main effects of treatment setting. However, interaction effects were found, such that more severe patients experienced better alcohol and drug outcomes following in-patient/residential treatment versus out-patient treatment; on the other hand, patients with lower baseline ASI drug severity had better drug outcomes following out-patient treatment than in-patient treatment. Treatment setting was unrelated to alcohol outcomes in patients with less severe ASI alcohol scores. CONCLUSIONS: Results provide some support to the matching hypothesis that for patients who have higher levels of substance use severity at intake, treatment in in-patient/residential treatment settings is associated with better outcomes than out-patient treatment. More research needs to be conducted before in-patient/residential settings are further reduced as a part of the SUD continuum of care in the United States.
AIMS: This study tested the hypothesis that patients with more severe substance use disorders (SUDs) at intake respond better when treated in more structured and intensive settings (i.e. in-patient/residential versus out-patient), whereas patients with less severe SUD problems have similar outcomes regardless of treatment setting. DESIGN, SETTING AND PARTICIPANTS: Up to 50 new patients were selected randomly from each of a random and representative sample of 50 Department of Veterans Affairs (VA) SUD treatment programs (total n = 1917 patients), and were followed-up an average of 6.7 months later (n = 1277). MEASURES: Patients completed a brief self-report version of the Addiction Severity Index (ASI) at baseline and at follow-up. FINDINGS: In mixed-model regression analyses, baseline substance use severity predicted follow-up substance use severity and there were no main effects of treatment setting. However, interaction effects were found, such that more severe patients experienced better alcohol and drug outcomes following in-patient/residential treatment versus out-patient treatment; on the other hand, patients with lower baseline ASI drug severity had better drug outcomes following out-patient treatment than in-patient treatment. Treatment setting was unrelated to alcohol outcomes in patients with less severe ASI alcohol scores. CONCLUSIONS: Results provide some support to the matching hypothesis that for patients who have higher levels of substance use severity at intake, treatment in in-patient/residential treatment settings is associated with better outcomes than out-patient treatment. More research needs to be conducted before in-patient/residential settings are further reduced as a part of the SUD continuum of care in the United States.
Authors: Matthew J Worley; Katie Witkiewitz; Sandra A Brown; Daniel R Kivlahan; Richard Longabaugh Journal: Alcohol Clin Exp Res Date: 2015-01 Impact factor: 3.455
Authors: Dennis McCarty; Lisa Braude; D Russell Lyman; Richard H Dougherty; Allen S Daniels; Sushmita Shoma Ghose; Miriam E Delphin-Rittmon Journal: Psychiatr Serv Date: 2014-06-01 Impact factor: 3.084
Authors: Maryam Bashiri; Michael J Mancino; Virginia A Stanick; Jeff Thostenson; Thomas R Kosten; Alison H Oliveto Journal: Am J Addict Date: 2017-11-08
Authors: Roger D Weiss; Margaret L Griffin; Jennifer Sharpe Potter; Dorian R Dodd; Jessica A Dreifuss; Hilary S Connery; Kathleen M Carroll Journal: Drug Alcohol Depend Date: 2014-04-24 Impact factor: 4.492